Individual
ATULYA ACHYUT DEODHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8963
Mailing address
2620 NW 83RD PL, PORTLAND, OR 97229-4151
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD21320
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077412
—
OR
Enumeration date
07/31/2006
Last updated
07/08/2007
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